Qualidade e desempenho das colpocitologias na prevenção de câncer de colo uterino

Abstract

Objective.To estimate prevalence rates and analyze the quality and performance of Pap smears carried out on the Cervical Cancer Screening Program in Maringá, Paraná, Brazil. MethOds. A retrospective search was run on the Brazilian Ministry of Health SIS-Colo database. Variables such as age, cervical cytology result and district of residence were analyzed. Ages were divided into bands; residence was classified according to the five regional healthcare districts of the city of Maringá. Cervical cytology results were categorized according to the Bethesda System. Cervical screening coverage was calculated by dividing the number of tests within the population aged 25 to 59 by the number of women in that age range. Results. The 17.664 cervical cytology specimens collected during 2005 by the public health system were distributed across women aged from 12 to 82 years, with 12,961 (73.4%) of these tests being on women in the 25 to 59 range, who are considered at higher risk of cancer. A total of 17,458 (98.84%) cytological examinations were negative for malignancy, and there were 206 (1.16%) atypical results (ASCUS/AGUS, LSIL, HSIL and invasive cancer). The study found a prevalence of 0.85% (151) for ASCUS/AGUS and of 1.14% (203/17,664) for atypical cells, and a ASCUS/atypical cells ratio of 2.75 (151/55). cOnclusiOns. The lower than expected prevalence of abnormal cervical cytology results and low proportion of ASCUS, the elevated ASCUS/atypical cells ratio, the insufficient population coverage of that cervical cytology and the elevated cervical cancer mortality rate all compromise the performance of the cervical cancer prevention program. The population with low socioeconomic status need special attention and the more privileged must be better informed about the need for regular tests and which age group is at greatest risk.

Policies and Programs for Cervical Cancer Prevention and Control in Public Health Services

“…These data are found in the study by Uchimura et al (2009), who recorded low colpocytologic change and ASCUS (Atypical Squamous Cells of Undetermined Significance) index in the following year. However, they state that this result can be linked to low quality diagnostics, and it increases the rate of false-negative exams [16,18] .…”

“…Regarding the analysis of factors related to UCN screening quality, human development inequality between different regions in the country and the lack of laboratory control over the analysis of cytopathological exams were identified in Brazilian and Argentinian studies, respectively [16,18,23] .…”

“…Articles gathered during the search described research conducted in many countries around the world. Six studies were carried out in Brazil [13,14,15,16,17,18] and four in the United States [19,20,21,22] . There was only one article from each of the following countries: Argentina [23] , Australia [24] , Canada [25] , England [26] , Italy [27] , Malawi [28] , Zambia [29] and United Kingdom [30] .…”

“…With regard to the treatment and diagnostic of precursor lesions identified in the target population, data from three Brazilian [16,18,17] , one Zambian [29] and one British studies [26] were identified.…”

Controle Do Câncer Do Colo Do Útero: Uma Análise Da Capacitação Dos Enfermeiros E Da Infraestrura Das Ubs

“…Novos casos podem ser evitados através de rastreamentos e acompanhamentos com o intuito de reduzir tratamentos mais complexos e dispendiosos decorrentes de diagnósticos tardios (UCHIMURA et al, 2009). Embora já tenham sido testados outros meios para a detecção do CCU, o exame citopatológico (Papanicolaou) ainda é a forma mais eficaz para a prevenção dessa neoplasia.…”